5% lidocaine medicated plaster use in children with neuropathic pain from burn sequelae

Pain Med. 2013 Mar;14(3):422-9. doi: 10.1111/pme.12020. Epub 2012 Dec 28.

Abstract

Objective: Neuropathic pain is a challenge in children with burn sequelae. Although relatively infrequent, the intensity and chronicity of neuropathic pain negatively impact functionality and quality of life. The use of 5% lidocaine medicated plaster has not previously been reported in children. We explored the effectiveness and safety of 5% lidocaine medicated plaster to treat neuropathic pain in children with burn sequelae.

Design: Three-month prospective, uncontrolled study.

Setting: Corporation of Aid to Burned Children (COANIQUEM), a nonprofit pediatric burn rehabilitation center in Chile.

Subjects: Fourteen pediatric patients with burn sequelae neuropathic pain.

Outcome measures: Demographics, burn and pain evolution (type, intensity [using Wong-Baker FACES], and Douleur Neuropathique 4 [DN4]), and patient functionality. Plasma lidocaine levels were measured at 0, 12, 36, and 60 hours after treatment commencement.

Results: Fourteen patients were evaluable for plasma lidocaine levels. Twelve patients were available for clinical assessment (two patients lost to follow-up) [mean (standard deviation)]: age, 11 years 7 months (2 years 6 months); weight, 45 kg (11.9 kg); burn evolution, 5 years 6 months (4 years); time between burn and pain onset, 3 years 6 months (3 years 2 months); time between pain onset and treatment, 5.1 months (4.8 months); lidocaine, between < and ½ plaster; initial pain intensity (FACES), 6.8 (1.6); final pain intensity, 0 in 11/12 patients; DN4, initial-6, final-2.3. All patients reported improved functionality. Plasma lidocaine levels were ≤27.45 ng/mL (>180 times below critical levels). No adverse reactions occurred.

Conclusions: These are the first published data suggesting that 5% lidocaine medicated plaster improves patient functionality, and is effective and safe for the treatment of neuropathic pain in pediatric patients with burn sequelae.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Cutaneous
  • Adolescent
  • Anesthetics, Local / administration & dosage*
  • Anesthetics, Local / blood
  • Bandages*
  • Burns / complications*
  • Child
  • Female
  • Humans
  • Lidocaine / administration & dosage*
  • Lidocaine / blood
  • Male
  • Neuralgia / drug therapy*
  • Neuralgia / etiology
  • Prospective Studies
  • Treatment Outcome

Substances

  • Anesthetics, Local
  • Lidocaine